pack iontophoresis-cats famose-cxl_zurich_2014
DESCRIPTION
Présentation faite au Xème congrés international sur le cross-linking du collagène cornéen (Zurich 5-6 décembre 2014). Lecture given during the Xth international congress of corneal collagen cross-linking, (Zurich 5-6 th december 2014)TRANSCRIPT
EVALUATION OF PACK-CXL AFTER
IONTOPHORESISFOR THE TREATMENT OF MELTING KERATITIS
IN 10 CATS
Dr Frank Famose – Toulouse - France
Pierre Roy – Paris - FranceZürich – december 6th, 2014
PACK-CXL Valuable tx for
melting keratitis
Sedation
Shortening of the
procedure
Iontophoresis
Application of a constant electric
current to enhance penetration
of a ionized substance through a
tissue
Aim of this study
To evaluate the clinical outcome
of feline melting keratitis
treated by accelerated CXL
after iontophoresis of riboflavin
Inclusion criteria
Cats
Corneal melting
Minimal Corneal
thickness > 300 µm
Protocol
Riboflavine
impregnation
Exposition
UVA 365 nm
Post-CXL
treatment
RF 0,1% (Ricrolin +TM)
Iontophoresis
5 min 1mA/min
30 mW/cm²
3 min
5,4J/cm²
TobrexTM BID
7 days
Accelerated protocol
(KXLTM – Avedro)
Follow-up
Inclusion D1 D4 D8 D15 D31
Pain (0-7) and clinical (0-18) scores
Ulceration and infiltration surfaces
0
2
4
6
8
10
12
D1 D4 D8 D15 D31
Evolution ofAverage scores
Clinical score Pain score
0
5
10
15
20
25
30
35
D1 D4 D8 D15 D31
Evolution of Average surfaces (mm²)
Ulcer surface Infiltration surface
Discussion : efficacy
Reduction of clinical
and pain score
Complete Epithelial
healing
Resolution of corneal melting
Duration of treatment ?
Instillation
30 min
Iontophoresis
5 min
Irradiation
30 min
Accelerated CXL
3-10 min
Conventional protocol
Duration > 1 hourIonto + acc. CXL protocol
Duration < 20 min.
Conclusion: IONTOPHORESIS
Results similar to
conventional instillation
Resolution of corneal melting
No adverse reaction or pain
Reduction of
procedure duration
